Understanding Risks For SIDS

New research helps clarify ways we can reduce risks for Sudden Infant Death Syndrome (SIDS) or Sudden Unexplained Death in infancy. A recent Pediatrics study found that the convergence of risks (see diagram below & listen to video) for infants is meaningful–reducing number of risks may reduce SIDS deaths. Avoiding multiple and simultaneous SIDS risks may help– especially for babies who are vulnerable due to family history, genetics, prematurity or prenatal exposures. Further, research published the same month in The American Journal of Public Health (April 2012) confirms that sleep environment hazards (co-sleeping, soft sleeping surfaces, shared sleep surfaces with people or animals) contribute to SIDS. 70% of infants who died from SIDS were sleeping in a surface not intended for infant sleep (adult bed, couch, chair) and 64% of infants who died were sharing a sleep surface, with half sharing with an adult. We can decrease SIDS risk by controlling our baby’s environment, knowing their vulnerabilities, and sharing what we know. Put babies on their backs without soft bedding (bumpers/pillows/blankets) in their own crib until 1 year of age.

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18 Comments to “Understanding Risks For SIDS”

What are your thoughts on the mesh bumpers, breathable bumpers? That’s what we’ve been using in our crib, and I’ve seen lots of bloggers holding them up as a safe alternative to normal bumpers, but haven’t heard an doctors agknowledge their existance, much less endorse them. My guess is there’s no data yet on whether they’re actually safer, but they do seem much safer. We’d always planned to have our crib completely empty, but as soon as our baby was mobile (pre-crawling) he invariably got a limb stuck between the crib slats. Breathable bumpers were the best compromise we could come up with.

Meagan,
Your assumptions are correct. I don’t know of any data supporting the use of mesh bumpers but there is also no data that finds injuries occur more often in babies without bumpers. The two studies below may help.

I remain equivocal mesh bumpers. I have no real reason to be concerned about a mesh (no soft or mushy parts) bumper but no real reason to endorse them.

When families inquire about them, I often talk about optimizing the sleep situation. If a parent is really wed to a mesh/breathable bumper it’s far superior in my mind to a soft, fluffy bumper.

Oh, I wasn’t really worried about injuries per say, he would just get stuck and freak the $@?# out! I’m sure he would have figured out how to get free eventually, but it was making sleep pretty impossible. Thanks though! He’s a year old now so I’m not as worried anyway (I even *gasp* risked giving him a tiny teddy bear to sleep with starting last week) I was just curious if you had any thoughts.

Important quote from the article:
“Australian doctors warned that the study was not sophisticated or big enough to draw conclusions and said parents did not need to act on the study.”

I’m not a doctor, but reading this I personally don’t think that parents who have no other choice than to feed their babies formula need to start worrying that they’re going to kill their babies by doing it.

As a pediatrician, one of the many things new parents want to know is how to prevent SIDS. Nothing is more terrifying to a new family than the thought of losing their baby. Thanks to Dr. Swanson who created this quick summary of very important information. I will certainly be sharing this with families.

Babies whose deaths are unexpected, are tragic. Over time, and through the dedication of talented researchers searching for a cause, patterns surrounding the deaths of these infants do emerge. And from these patterns, we can humbly learn. In some way, allowing painful death to protect life.

Few “elephants” have been left un-probed, or remain hidden. And unlike Cathy’s obtuse claim that vaccinations are a risk-factor for SIDS, her comment is simply a reflection of her personal life experience which has altered her perception of risk.

Cathy’s perception is false, and NOT consistent with research to date.

The reality is that the relationship between SIDS and vaccination status has been looked at, and looked at again. There are many studies, including an analysis from the IOM, describing the LACK of data to support vaccinations as a SIDS risk-factor.

In the face of this country’s pockets of potentially fatal pertussis; casually spreading misinformation in an online space of discussion is irresponsible, and distracting. Instead, I believe we should focus on protecting our infants from SIDS though evidence-based knowledge of the extrinsic and intrinsic risks as Dr. Swanson described. Armed with knowledge, we can continue to make the best choices for the children in our families, and confidently encourage others to do the same.

With all the things you can “do” or “not do” to prevent SIDS – I’ve read that monitors have been found to not reduce the risk but I’ve never seen a study referenced or seen the data for myself. My personal opinion is that they DO help! I would never sleep again if I didn’t have the Snuza Halo movement monitor for my sweet baby. I know and follow the advice from the Back to Sleep Campaign, but even still SIDS can happen so I want to know when my baby is and isn’t breathing and I want to know immediately. In my mind, if I get an alert and can try to help her, at least I would be able to know that I did EVERYTHING in my power to prevent it, and hopefully successfully perform CPR or unblock her airway to get her breathing again.

I agree with your feeling that the monitor gives you peace of mind. Trouble is, these cardiorespiratory monitors don’t have a good track record for reducing deaths from SIDS. See the quote below (likely similar to what you’ve already seen) and the studies that I linked to thereafter. You’ll be able to see and review the data for yourself. And talk with your pediatrician. There are some babies who do benefit from these monitors (babies on oxygen therapy, babies with heart abnormalities, etc).

Quoted from The AAP 2011 SIDS guidelines:

“Do not use home cardiorespiratory monitors as a strategy to reduce the risk of SIDS—
Although cardiorespiratory monitors can be used at home to detect apnea, bradycardia, and, when pulse oximetry is
used, decreases in oxyhemoglobin saturation, there is no evidence that use of such devices decreases the incidence of SIDS.

They might be of value for selected infants but they should not be used routinely.”

[…] from 1991 to 2008, providing insights into the underlying mechanisms of this tragic syndrome. In this video, Seattle Mama Doc, Dr. Wendy Sue Swanson, summarizes the key findings of this study and offers […]

If you pay attention to the stroke-like symptoms some children have after vaccination: crooked smiles, strabismus, a lopsided crawl, it becomes quite clear what is going on. Aluminum causes blood platelet sticking (coagulation), takes the place of iron on transferrin receptors and starves the brain of oxygen. If the children are lucky, they sometimes just have myoclonic jerks – now called “benign” infantile spasms as the poisons pass through their nervous system. Quotes and references:

“In the present study when the effect of free and transferrin bound aluminium on oxygen uptake by rat liver isolated mitochondria was investigated, there was 18 and 32 percent eduction of oxygen uptake by free and transferrin bound aluminium respectively. These observations are in good agreement with those of Heffron et al. (20) who have found that oxygen reduction was observed when mitochondria were incubated with aluminium.”

“The SIDS group also had a significantly lower (P < 0.05) number of reactive neurons in the CA2 and CA3 areas of the hippocampus than did control group two. No difference was detected between the SIDS group and control group one. The SIDS brains were thus found to display hypoxic/ischemic features without however providing evidence as to the cause of the oxygen reduction.”

“Aluminum chloride (AlCl(3); 4 mg/kg) was injected into the cerebrospinal fluid of adult rats as a one time dose. Rapid Golgi stained sections of hippocampus were examined for detailed histology of neurons in CA1, CA2, and CA3 areas. The axonal length and number of dendritic branches were seen reduced 30 days later in aluminum (Al)-injected group when compared to vehicle-injected controls. Of these perturbations, dendritic branches were seen reduced significantly. Al toxicity apparently affects neuronal connectivity in hippocampus.”

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Seattle Children’s provides healthcare for the special needs of children regardless of race, color, creed, national origin, religion, sex (gender), sexual orientation or disability. Financial assistance for medically necessary services is based on family income and hospital resources and is provided to children under age 21 whose primary residence is in Washington, Alaska, Montana or Idaho.